Patient-Centered Care in Gender-Affirming Surgical Reversal: A Case Report of Breast Reconstruction Using Autologous Fat Grafting and Discussion on Reversal, Detransition, and Regret.

Abstract

Utilization of gender-affirming surgery has increased significantly over the past 15 years, while the prevalence of surgical reversal and regret remains very low. Nonetheless, these phenomena have recently attracted considerable media and political attention. This report presents a case of surgical reversal without regret following gender-affirming mastectomy utilizing a novel approach using staged autologous fat grafting alone. We further explore the distinct concepts of surgical reversal, detransition, and regret, emphasizing patient-centered discussions to enhance understanding of patient perspectives. By fostering a comprehensive understanding of the patient experience and the complex interrelationships among detransitioning, surgical reversal, and regret, gender-affirming surgeons can deliver compassionate, affirming care throughout their patients' surgical experience.